{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:09:29Z","timestamp":1790834969243,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To identify textural features on dual-energy CT (DECT)\u2013based bone marrow images in myeloma which correlate with serum markers of myeloma activity and the degree of medullary involvement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 110 patients (63.0\u2009\u00b1\u200911.0\u00a0years, 51 female) who underwent unenhanced whole-body DECT between September 2015 and February 2019 were retrospectively included, which was approved by our institutional ethics committee with a waiver of the informed consent requirement. All patients had current hematologic laboratory tests. Using DECT post-processing, non-calcium bone marrow images were reconstructed. The vertebral bodies T10\u2013L5 were segmented for quantification of textural features, which were compared with serologic parameters and myeloma stages by the Mann-Whitney <jats:italic>U<\/jats:italic> test. In a subgroup of 56\/110 patients with current bone marrow biopsies, textural features were correlated with the degree of bone marrow infiltration.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>First-order features were higher in patients with advanced stage of myeloma (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.02), whereas the 2nd-order \u201cgray-level co-occurrence matrix (GLCM) cluster prominence\u201d was lower (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.04). In patients with elevated serum-free light chains (SFLC) or kappa\/lambda SFLC ratio above 1.56, the \u201centropy\u201d and 2nd-order GLCM features were lower (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.03). The degree of bone marrow infiltration correlated with 1st-order features (e.g., \u201cuniformity\u201d; <jats:italic>r<\/jats:italic><jats:sub>P<\/jats:sub>\u2009=\u20090.49; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001), whereas \u201centropy\u201d and 2nd-order GLCM features were negatively correlated (e.g., \u201cdifference entropy\u201d; <jats:italic>r<\/jats:italic><jats:sub>P<\/jats:sub>\u2009=\u2009\u2212\u20090.54; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>CT textural features applied on non-calcium bone marrow images correlate well with myeloma-related serologic parameters and histology showing a more uniform tissue structure and higher attenuation with increasing medullary infiltration and could therefore be used as additional imaging biomarkers for non-invasive assessment of medullary involvement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Texture analysis applied on dual-energy reconstructed non-calcium bone marrow images provides information about marrow structure and attenuation.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Myeloma-related serologic parameters and the degree of myeloma cell infiltration correlate with 1st- and 2nd-order features which could be useful as additional imaging biomarkers for non-invasive assessment of medullary involvement.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-020-07320-8","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T17:02:56Z","timestamp":1601744576000},"page":"2357-2367","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Role of computed tomography texture analysis using dual-energy-based bone marrow imaging for multiple myeloma characterization: comparison with histology and established serologic parameters"],"prefix":"10.1007","volume":"31","author":[{"given":"Christian Philipp","family":"Reinert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Krieg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Esser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Nikolaou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"B\u00f6sm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Horger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,3]]},"reference":[{"key":"7320_CR1","doi-asserted-by":"crossref","unstructured":"Schreiman JS, McLeod RA, Kyle RA, Beabout JW (1985) Multiple myeloma: evaluation by CT. 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Konstantin Nikolaou received institutional research funds and speaker\u2019s honorarium from Siemens Healthineers and is a scientific advisor of Siemens Healthcare Germany. The other authors have declared that no competing interests exist.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Dr. Christian Philipp Reinert has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Our study protocol was approved for retrospective evaluation of patient data by our institutional ethics committee with a waiver of the informed consent requirement (project number 019\/2019BO2).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 retrospective\u2022 diagnostic or prognostic study\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}